NPIMap

Individual provider Active NPI

Amy O. Bratteli, MD

  • Family Medicine Physician
  • Fruita, CO
National Provider Identifier
1336122019
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DR.0042682 Issued in CO
Practice address
455 Kokopelli Blvd Ste C
Fruita, CO 81521-8710
Phone
(970) 256-5285
Fax
(970) 256-5290
NPI assigned
Nov 28, 2005
Last updated
Aug 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X DR.0042682 CO Primary

Addresses

Primary practice location

455 Kokopelli Blvd Ste C
Fruita, CO 81521-8710

Mailing address

550 Lois Dr
Fruita, CO 81521-8764
Phone (970) 240-8240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040805000417 CO Practitioner - Family Practice 6204807829 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Dakota School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

456 Kokopelli Blvd
Unit B
Fruita, CO 81521-8723
Phone (970) 639-2627

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0042682COMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harmony HRT LLC Family Medicine CurrentSince Oct 1, 2021 Accepting new patients
St Mary's Hospital and Medical Center, Inc Family Medicine Current Accepting new patients
St Mary's Hospital and Medical Center, Inc CurrentSince Jul 24, 2018 Accepting new patients
St Mary's Hospital and Medical Center, Inc CurrentSince Jul 24, 2018 Accepting new patients
Lakeshore Radiology Associates SC Past Accepting new patients
Holy Family Memorial Inc Past Accepting new patients

Locations

456 Kokopelli Blvd
Unit B
Fruita, CO 81521
Phone (970) 639-2627

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

2698 Patterson Rd
Grand Junction, CO 81506
Phone (970) 298-2800

Interoperability endpoints

  • Direct secure messaging: amy.bratteli.1@24090.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24090/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1336122019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LOIS DR",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815218764",
            "telephone_number": "970-240-8240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 KOKOPELLI BLVD STE C",
            "city": "FRUITA",
            "state": "CO",
            "postal_code": "815218710",
            "telephone_number": "970-256-5285",
            "fax_number": "970-256-5290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTELI",
        "first_name": "AMY",
        "middle_name": "O.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0042682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fruita, CO

Sources for this page

Verify at the official NPI Registry.